{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:08:46Z","timestamp":1792789726857,"version":"4.5.0"},"reference-count":31,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pfizer Global Medical Grants","award":["#54699605"],"award-info":[{"award-number":["#54699605"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Carbapenem-resistant Enterobacteriaceae (CRE) pose an emerging threat, with a high mortality rate among children with cancer. This study aimed to evaluate the impact of routine rectal swab surveillance and rapid PCR-based detection of carbapenemase genes to facilitate the early initiation of appropriate treatment and assess its effects on outcomes. The study compared two groups of pediatric cancer patients with CRE bloodstream infections: a retrospective cohort of 254 patients from 2013 to 2017, and a prospective cohort of 186 patients from 2020 to 2022, following the implementation of these tools. A rapid diagnostic test in the prospective cohort resulted in the early initiation of proper antibiotics in 85% (165\/186) of patients, compared to only 58% (147\/254) in the retrospective group. This led to a decrease in the need for ICU admission related to sepsis from CRE and a significant reduction in the 30-day mortality rate (16% vs. 30%, p \u2264 0.01). Genotypic profiling revealed that class B carbapenemases were the most prevalent (69%), with the NDM type being identified in 67% of patients. OXA-48 and KPC enzymes were detected in 59% and 4% of patients, respectively. Multivariate analysis revealed that patients having Klebsiella pneumoniae, NDM genotype carbapenemases, presence of pneumonia, and septic shock requiring ICU admission were predictors of poor outcomes. Rapid diagnostics and targeted colonization lead to the appropriate use of targeted antibiotics, resulting in improved patient outcomes. Understanding carbapenemase-producing microorganisms and administering newer antibiotics may further reduce mortality and enhance treatment strategies for high-risk patients.<\/jats:p>","DOI":"10.3390\/microorganisms13071627","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T15:36:58Z","timestamp":1752161818000},"page":"1627","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Carbapenem-Resistant Enterobacteriaceae (CRE) in Children with Cancer: The Impact of Rapid Diagnostics and Targeted Colonization Strategies on Improving Outcomes"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0511-1562","authenticated-orcid":false,"given":"Youssef","family":"Madney","sequence":"first","affiliation":[{"name":"Pediatric Oncology Department, Children\u2019s Cancer Hospital Egypt (CCHE-57357), Cairo 11311, Egypt"},{"name":"Pediatric Oncology Department, National Cancer Institute, Cairo University, Cairo 12613, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4465-5891","authenticated-orcid":false,"given":"Sally","family":"Mahfouz","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department, Children\u2019s Cancer Hospital Egypt (CCHE-57357), Cairo 11311, Egypt"},{"name":"Pediatric Oncology Department, National Cancer Institute, Cairo University, Cairo 12613, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0086-1466","authenticated-orcid":false,"given":"Ahmed","family":"Bayoumi","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department, National Cancer Institute, Cairo University, Cairo 12613, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omayma","family":"Hassanain","sequence":"additional","affiliation":[{"name":"Research Department, Children\u2019s Cancer Hospital Egypt (CCHE-57357), Cairo 11311, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omneya","family":"Hassanain","sequence":"additional","affiliation":[{"name":"Research Department, Children\u2019s Cancer Hospital Egypt (CCHE-57357), Cairo 11311, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4044-4709","authenticated-orcid":false,"given":"Ahmed A.","family":"Sayed","sequence":"additional","affiliation":[{"name":"Genomic and Metagenomics Research Program, Department of Basic Research, Children\u2019s Cancer Hospital Egypt (CCHE-57357), Cairo 11311, Egypt"},{"name":"Department of Biochemistry, Faculty of Science, Ain Shams University, Cairo 11566, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deena","family":"Jalal","sequence":"additional","affiliation":[{"name":"Genomic and Metagenomics Research Program, Department of Basic Research, Children\u2019s Cancer Hospital Egypt (CCHE-57357), Cairo 11311, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2108-5633","authenticated-orcid":false,"given":"Maryam","family":"Lotfi","sequence":"additional","affiliation":[{"name":"Genomic and Metagenomics Research Program, Department of Basic Research, Children\u2019s Cancer Hospital Egypt (CCHE-57357), Cairo 11311, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8723-252X","authenticated-orcid":false,"given":"May","family":"Tolba","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Services and Sciences, Children\u2019s Cancer Hospital Egypt (CCHE-57357), Cairo 11311, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3364-3429","authenticated-orcid":false,"given":"Ghada A.","family":"Ziad","sequence":"additional","affiliation":[{"name":"Microbiology Unit, Children\u2019s Cancer Hospital Egypt (CCHE-57357), Cairo 11311, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mervat","family":"Elanany","sequence":"additional","affiliation":[{"name":"Microbiology Unit, Children\u2019s Cancer Hospital Egypt (CCHE-57357), Cairo 11311, Egypt"},{"name":"Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo 12613, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5563-765X","authenticated-orcid":false,"given":"Mohamed","family":"Hashem","sequence":"additional","affiliation":[{"name":"Research Department, Children\u2019s Cancer Hospital Egypt (CCHE-57357), Cairo 11311, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gehad","family":"Taha","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Children\u2019s Cancer Hospital Egypt (CCHE-57357), Cairo 11311, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lobna","family":"Shalaby","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department, Children\u2019s Cancer Hospital Egypt (CCHE-57357), Cairo 11311, Egypt"},{"name":"Pediatric Oncology Department, National Cancer Institute, Cairo University, Cairo 12613, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3538-5038","authenticated-orcid":false,"given":"Alaa","family":"Elhaddad","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department, Children\u2019s Cancer Hospital Egypt (CCHE-57357), Cairo 11311, Egypt"},{"name":"Pediatric Oncology Department, National Cancer Institute, Cairo University, Cairo 12613, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1093\/cid\/ciu069","article-title":"Treatment of Multidrug-Resistant Gram-Negative Infections in Children","volume":"58","author":"Hsu","year":"2014","journal-title":"Clin. 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